Journal
ACG CASE REPORTS JOURNAL
Volume 8, Issue 4, Pages -Publisher
LIPPINCOTT WILLIAMS & WILKINS
DOI: 10.14309/crj.0000000000000560
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An 87-year-old man presented with altered mental status and ataxia, and was found to have a neuron-restricted antibody in his cerebrospinal fluid, raising concern for a paraneoplastic syndrome. Further imaging revealed abdominal lymphadenopathy, and push enteroscopy confirmed a jejunal mass, ultimately diagnosed as malignant mesothelioma. Malignant mesothelioma is more common in men, limited to the small bowel, and paraneoplastic syndromes associated with it are rare and have a poor prognosis.
An 87-year-old man presented with altered mental status and ataxia was found to have a neuron-restricted antibody in his cerebrospinal fluid, concerning for a paraneoplastic syndrome of unknown origin. He also exhibited anemia, but otherwise normal electrolytes and liver chemistries. He underwent positron emission tomography/computed tomography which revealed abdominal lymphenopathy. He then underwent push enteroscopy and was found to have a jejunal mass, biopsy proven to be malignant mesothelioma. Malignant mesothelioma is 4-5 times more prevalent in men than women. It is limited to the small bowel, and paraneoplastic syndromes are extremely rare and carry a poor prognosis. The presence of anemia with cerebellar symptoms should trigger a search for a paraneoplastic syndrome-related malignancy.
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